Why Does a Pulmonologist Care About Obesity?

Probably the question I get asked most frequently when people find out that I wrote a book on weight loss is, ‘Did you used to be overweight?’.  The premise of the question is not unfounded.  There are many people who, having been successful at significant weight loss, want to share their experience and secrets with others.  If you’re curious, the answer is no.  Aside from a brief pudgy pre-pubescent awkward phase, I have never been overweight (adolescence is just cruel). While it is true I have never been overweight, I have never smoked, had cancer, or heart disease, yet it I work constantly to help people avoid and recover from these conditions.

The next most common question I get is, ‘Why does a pulmonologist care aboutweight loss?’.  This is more nuanced, but the week I had working in the hospital made me want to share some experiences with you to help you understand why I care about obesity and why you should to.  To begin with, I am both a lung doctor and an intensive care specialist.  These usually go together because many patients in the ICU are on ventilators which requires some expertise in lung function to manage.

It’s been a busy week in the ICU.  Much of my work has been due to obesity related conditions.  Here’s a synopsis:

DG is a very obese male who has chronic back pain.  The human spine is not designed to carry around all the extra weight and it causes chronic pain. DG takes prescription narcotic pain medication.  The main scary side effect of these drugs is that they suppress the drive to breathe.  Further, while his body has grown larger, his lungs have not.  The result is that they are literally squeezed by the weight from his fat and he is unable to breathe sufficiently.  The end result is that he is unable to remove the carbon dioxide from his body.  This is called the obesity hypoventilation syndrome (OHS).  So his medication and his weight decrease his ability to breathe.  So, earlier this week, he stopped breathing.  He had a cardiac arrest at home. It is an event that would have been prevented if he had lost weight.

K is in the room next to DG.  She is also morbidly obese and also has OHS.  Her condition is so severe that she had to have a tube surgically inserted into her neck to allow a machine to help her breathe long term (aka a tracheostomy).  A side effect of the tracheostomy is that it makes it unsafe for her to swallow so she also had to have a feeding tube placed in her stomach.  She may never eat again.  There is some irony in there.  All of this could have been avoided with weight loss.

DM across the hall is in the ICU with an overwhelming gallbladder infection, septic shock, and kidney failure.  Because of his obesity, we had to try multiple times in multiple locations to place a dialysis catheter in.  If you were present for this gruesome experience you would preach to the world about weight loss as well.

These were just a few cases from yesterday.  You can check out my post from a couple years ago for some more (Obesity Horror Stories) The intensive care unit is where the sickest patients with the most advanced diseases come.  Every day I work there I see the most horrific complications of this terrible epidemic.  The problem is that by the time they get to the ICU, it’s usually too late for weight loss to make a difference.

That’s why I keep up this blog and why I wrote my book (The Weight Loss Counter Revolution).  I see people everywhere with obesity and the only thing I can think about is the terror and suffering that they face in the future if they don’t change their lifestyle.  It is my hope that by educating people about how their body works in a way that can empower them to successfully and permanently achieve a healthy weight, I can help them stay out of my ICU so I don’t have to see them suffer so much.

You can be a part of this counter revolution.  I am asking you to please spread the word.  Post a link to this blog on Facebook, Tweet it, tell your friends and family, shout it from the mountain tops.  If we can spread the message, hopefully we can make a difference.